Effects of endoscopic sinus surgery on pulmonary artery pressure in patients with extensive nasal polyposis

Nasal Polyposis and Its Association with Cardiac Functions

OBJECTIVE

The aim of the study was to ascertain the effect of nasal polyposis on cardiac functions.

MATERIAL AND METHODS

A prospective randomized interventional open-label endpoint-controlled study was conducted in an academic tertiary care hospital. Thirty-one patients with chronic rhinosinusitis with nasal polyposis were enrolled and administered fluticasone furoate nasal spray for 3 weeks before randomly segregation into surgical or medical group. The treatment continued for 3 months in both groups. The SNOT-22 (Sino-Nasal Outcome Test-22) score, polyp grade, and right ventricular and pulmonary arterial functions were recorded in both groups before and after 3 months of the intervention.

RESULTS

Both groups had significant improvement in SNOT-22 scores after 3 months of intervention. Both groups showed improvement in cardiac functions, but statistical significance was found only in subjects who underwent surgery.

CONCLUSION

Nasal polyp affects cardiac functions, and this needs further evaluation and research through studies on large samples.

Effect of endoscopic sinus surgery on plasma asymmetric dimethylarginine levels in patients with extensive nasal polyposis

OBJECTIVE

This study examined the effect of endoscopic sinus surgery (ESS) on plasma levels of asymmetric dimethylarginine (ADMA) and mean pulmonary arterial pressure (mPAP) in patients with extensive nasal polyposis (ENP).

METHODS

Preoperative and 3 month post-ESS plasma levels of ADMA and mPAP were measured in patients with ENP and in age-and gender-matched controls.

RESULTS

The study included 45 patients with ENP and 31 controls (mean ± SD age 39.4 ± 8.8 and 38.1 ± 9.6 years, respectively). The mean preoperative ADMA level in ENP patients (0.69 ± 0.27 μmol/l) was statistically significantly lower than in the control group (1.08 ± 0.37 μmol/l). The postoperative ADMA level increased significantly in ENP patients (0.97 ± 0.36 μmol/l) versus the preoperative level. Mean preoperative mPAP in ENP patients (25.7 ± 5.4 mmHg) was statistically significantly higher than in the control group (20.8 ± 2.1 mmHg), and ENP patients showed significant decreases in mPAP after (21.9 ± 3.5 mmHg) versus before ESS.

CONCLUSION

Patients with ENP had lower plasma ADMA levels compared with healthy controls, however ADMA levels and mPAP improved in ENP patients after ESS.